Does left molar approach to laryngoscopy make difficult intubation easier than the conventional midline approach?

Abstract

Left molar laryngoscopy can make unexpected difficult intubation easier and should be attempted in cases of difficult intubation.

A comparison between left molar direct laryngoscopy and the use of a Bonfils intubation fibrescope for tracheal intubation in a simulated difficult airway

“…24 Bozdogan et al also found that the LM approach improved the view in 90% (18/20) of patients who had a difficult midline laryngoscopy, although tracheal intubation could not be performed in 35% (7/20) of these patients. 13 The narrow space and a bulging tongue over the blade obscured the view of the glottis and made tracheal intubation difficult under vision.…”

“…The glottic view is improved using a left molar (LM) approach; 11,12 however, it may be difficult to intubate with the tongue bulging on the medial side. 13 Intubation aids such as endotracheal tube introducers (long and thin with a curved tip) can be manipulated through the narrow space created during LM laryngoscopy and thus may improve the overall intubation success rate. Formal studies are lacking on intubation using the tube introducer-assisted LM laryngoscopy approach and on comparisons with the BIF approach to intubation.…”

Left molar approach of laryngoscopy for pediatric patients with uncorrected cleft palate

“… with interest. We are pleased that our study on left molar approach to laryngoscopy for difficult intubation was cited with the reference number ten . Yamamoto et al .…”

“… firstly showed that the left molar approaches of laryngoscopy provided a better laryngeal view than did the standard midline approach, and authors suggest the left molar approach when intubation was difficult. We prefer the left molar approach of laryngoscopy as the primary alternative when the conventional midline approach fails since 2007 . We also use the left molar approach of laryngoscopy in cases of difficult intubation in pediatric and adult patients in our anesthesia clinic.…”

Difficult airway rescued by a gamjee

“…The left molar approach has been shown to improve the laryngoscopic view in difficult laryngoscopy situations. [34]…”